Banner Health Job - 32928405 | CareerArc
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Company: Banner Health
Location: Mesa, AZ
Career Level: Mid-Senior Level
Industries: Healthcare, Pharmaceutical, Biotech

Description

The future is full of possibilities. At Banner Staffing Services, we're excited about what the future holds for health care. Our team has come together with the common goal: Make health care easier, so life can be better.  If you're ready to change lives, we want to hear from you.

 

As the internal staffing (registry) provider for Banner Health, Banner Staffing Services (BSS) provides opportunities within one of the country's leading health systems. The BSS team is dedicated to providing personal attention and professional support for its employees. Registry opportunities are a great way to market your skills within Banner Health. As a BSS employee, you are eligible to apply (at any time) as an internal applicant to any regular full-time or part-time opportunities within Banner Health.            

 

In addition, registry employment through BSS offers:

  • Competitive wages
  • Paid orientation
  • Flexible Schedules (select positions)
  • Fewer Shifts Cancelled
  • Weekly pay
  • 403(b) Pre-tax retirement plan
  • Employee Assistance Program
  • Employee wellness program
  • Discount Entertainment tickets
  • Restaurant/Shopping discounts
  • Auto Purchase Plan

 

BSS Registry positions do not have guaranteed hours and no medical benefits package is offered. BSS requires: Completion of post-offer Occupational Health physical assessment, drug screen and background check (includes; employment, criminal and education).

If you are a New Graduate Nurse with less than 12 months of experience, please apply to our New Nurse Experience openings.

 

 

About Banner Staffing Service AZ
Supporting Banner Health, Banner Staffing Services offers a world of opportunities to make an impact on one of the country's leading health systems. In addition, Staffing Services provides the best training in the business, so you can hit the ground running as you enjoy unequaled clinical variety, professional flexibility and lifestyle choices. We provide registry and travel assignments throughout the western United States. The registry allows you to create your own schedule by offering opportunities in a variety of hospital, home care and primary care settings. Banner Travel offers short-term assignments of three twelve-hour shifts per week. Our pay rates are highly competitive, and we offer training in the country's most advanced simulation center. You will also enjoy the stability only an organization as large and successful as Banner Health can offer.

 

About Banner Health
Banner Health is one of the largest, nonprofit health care systems in the country and the leading nonprofit provider of hospital services in all the communities we serve. Throughout our network of hospitals, primary care health centers, research centers, labs, physician practices and more, our skilled and compassionate professionals use the latest technology to make health care easier, so life can be better. The many locations, career opportunities, and benefits offered at Banner Health help to make the Banner Journey unique and fulfilling for every employee.

Job Summary

Provides support and execution of programs and tactics used to influence provider and health Plan consumer/beneficiaries behaviors in order to achieve right care in the right place at the right time and the appropriate cost. Plans and provides support for health plan consumers/beneficiaries to align with the objectives of triple aim. This position is responsible to process health plan medical pre-service requests, provide case management, care coordination and perform utilization management duties within the appropriate time period as outlined in the Medical Management Program Descriptions, and in accordance with all federal and state regulations.

 

Essential Functions

  • Manages health Plan consumer/beneficiaries across the health care continuum to achieve optimal clinical, financial, operational, and satisfaction outcomes.

 

  • Provides pre-service determinations, concurrent review, and case management functions within Medical Management. Ensures quality of service and consistent documentation.

 

  • Works collaboratively with both internal and external customers in assisting health Plan consumer/beneficiaries and providers with issues related to prior authorization, utilization management, and/or case management. Meets internal and external customer service expectations regarding duties and professionalism.

 

  • Performs transfer of accurate, pertinent patient information to support the pre-service determination(s), the transition of patient care needs through the continuum of care, and performs follow-up calls for advanced care coordination. Documents accurately and timely, all interventions and necessary patient related activities in the correct medical record.

 

  • Evaluates the medical necessity and appropriateness of care, optimizing health Plan consumer/beneficiaries outcomes. Identifies issues that may delay patient services and refers to case management, when indicated to facilitate resolution of these issues, pre-service, concurrently and post-service.

 

  • Provides ongoing education to internal and external stakeholders that play a critical role in the continuum of care model. Training topics consist of population health management, evidence based practices, and all other topics that impact medical management functions.

 

  • Identifies and refers requests for services to the appropriate Medical Director and/or other physician clinical peer when guidelines are not clearly met. Conducts call rotation for the health plan, as well as departmental call rotation for holiday.

 

  • Maintains a thorough understanding of each plan, including the Evidence of Coverage, Summary Plan Description authorization requirements, and all applicable federal, state and commercial criteria, such as CMS, MCG, and Hayes.

 

 

Minimum Qualifications

Requires Registered Nurse (R.N.) licensure in the state of practice. All license or certification must identify the issuing state or entity, type of licensure and expiration date or evidence that the certification is the type that does not expire. A bachelors degree or equivalent experience. Requires proficiency level typically achieved with 5 years of clinical experience. Basic Life Support (BLS) certification is also required.

Must have a working knowledge of care management, acute care and/or home care environments, community resources and resource/utilization management. Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, and time management skills. Must demonstrate ability to work effectively in an interdisciplinary team format. Must be able to work flexible hours and take rotating call after hours.

Preferred Qualifications

Certification(s) related to field, such as Certified Case Manager (CCM), MCG Certification(s), RN-BC Registered Nurse Case Manager, Certification in Managed Care Nursing (CMCN).

Additional related education and/or experience preferred.


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